ABSTRACT
Six patients with recalcitrant post-traumatic humeral shaft non-unions were treated
using vascularized bone grafts from the supracondylar region of the femur. The initial
state of injury showed that four fractures were closed, while two were open fractures.
At the acute stage, five fractures were fixed using intramedullary nailing, while
one was fixed with a plate. In all patients, a bony flap was placed on the cortex
after decortication. The size of the harvested bone flap ranged between 4 × 2.5 cm
and 5 × 3 cm. After fixation of the bony flap, the inferior genicular artery and vein
were anastomosed to the deep brachial artery and vein. The mean time required to obtain
radiographic bone union was 3.3 months. The only graft-site complication involved
transient mild paresthesia in the saphenous nerve area in one patient. This procedure
was useful for atrophic nonunions without substantial bone defects of the humeral
shaft.
KEYWORDS
Vascularized bone graft - humerus - non-union - femur
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Hiroshi YajimaM.D.
Department of Orthopaedic Surgery, Nara Medical University
840 Shijo-cho, Kashihara 634-8522, Japan
